Provider Information for 1073865770
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TRACY S THOMPSON LMHC
Sex: Female
NPI: 1073865770
Last Updated: 2020-08-27
Certification Date: 2020-08-27
Certification Date: 2020-08-27
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1073865770 | ||||||||
| Enumeration Date | 2012-10-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 602 VILLA CIR BOYNTON BEACH, FL 33435-8913 United States Phone: 314-853-8371 | Fax: | ||||||||
| Primary Practice Address | 602 VILLA CIR BOYNTON BEACH, FL 33435-8913 United States Phone: 314-853-8371 | Fax: | ||||||||
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